| NPI | 1376738096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD D SHANSHALA II Director 603-444-2464 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2009-03-19 |